In late April 2009, an unusual virus was noted in Mexico and southern California. Within weeks, most North Americans had heard about ‘swine flu.’ Now, it is known as Pandemic (H1N1) influenza.
Influenza viruses are always changing. As this strain of H1N1 is slightly different from other influenza viruses that have been circulating recently, most people are not immune to it. That, combined with the high amount of global travel, allowed this strain to spread rapidly around the world. As a result, the World Health Organization (WHO) has classified it as their highest level of pandemic, Level 6. A pandemic refers to increased amounts of disease occuring over most or all of the world. Fortunately, so far the illness has only been mildly to moderately severe in most people.
Pandemic (H1N1) 2009 is a new strain of influenza. However, symptoms are similar to seasonal influenza. They include fever, cough, muscle aches, fatigue and lack of appetite. Some people have had a runny nose, sore throat, nausea, vomiting and diarrhea.
Influenza spreads in droplets. Someone with influenza, who is coughing and sneezing, can spread influenza particles in the air to anyone within one to two metres. It is also passed on through contact, whether direct or indirect. A shared object like a doorknob, toy or telephone can be a source of germs.
After exposure, it usually takes one to four days to become ill. Someone with influenza can spread it from a day before symptoms appear until about five to seven days afterward.
It is not always easy to know if influenza is around. Adopting good habits that protect against many different illnesses makes sense. Hand washing and covering coughs and sneezes are simple measures. These easy, inexpensive methods protect health and reduce the spread of influenza. If soap and water are not available, waterless hand sanitizer with at least 60 per cent alcohol content is a good choice as long as hands are not visibly dirty.
People with other illnesses like asthma, diabetes and heart disease, as well as pregnant women, may want to avoid large crowds during influenza season as an extra measure of protection.
So, what if you do get influenza? Most people who become sick with H1N1 have mild to moderate illness. For most healthy people, it is best to stay at home and treat symptoms. This includes fluids, rest, and over-the-counter pain or fever medications when needed. Those who have a chronic illness, shortness of breath, chest pain, or other concerning symptoms should get medical help. Sick babies under six months of age should also see a doctor.
In certain situations, antiviral medication can be used to prevent influenza after being exposed, or to lessen symptoms once ill. However, they have limited benefit, and cases of resistance are already developing. In Canada, a doctor must prescribe these medications. They are usually prescribed only under limited conditions, such as for people who already have another illness.
Antibiotics do not work against viruses, including influenza. They are only effective against infections from bacteria. Sometimes, illness may return after recovery from influenza. In this case, it is important to be checked by a doctor, as it could indicate a bacterial illness. For instance, pneumonia is a bacterial infection that can be treated with antibiotics.
Immunization against seasonal strains of influenza has been one of the best defences against the virus. Pandemic (H1N1) 2009 started too late in the influenza season to be included in the seasonal influenza vaccine this year. Instead, two vaccines will be needed this season for adequate protection against both H1N1 and seasonal influenza. There are many good reasons to get the influenza vaccine, including chronic illness (diabetes, heart/lung/kidney disease, asthma or cancer), age (under 2 or over 65), pregnancy or contact with people in these groups, such as household members, health care workers and daycare workers. As vaccine arrangements may differ from province to province, look for local information about vaccine clinics.
Be prepared for a personal emergency. Have enough food, water, clothing and medication on hand to last 72 hours. It is also worth thinking about what a bout of illness in the household might require. Do you have comfort supplies like canned chicken soup, and medication to relieve fever like acetaminophen or ibuprofen?
If you have sick seniors or children in your family, you may need to take time off work to provide care. You might be able to rearrange your schedule to work from home. This may be worth discussing with your employer ahead of time.
Frequent updates on H1N1 are being given. The Public Health Agency of Canada website www.fightflu.ca contains general information on H1N1. You can find details for specific groups like businesses, and instructions for caring for a sick person at home. Links to provincial and territorial sites are also included.
Much uncertainty exists about the course of this particular strain of H1N1. However, we can count on one thing - the influenza virus is always changing. We must stay informed and use as many preventive measures as possible to limit spread.